Ingrown toenails are painful nails that dig into the skin at the sides of the nail. Skin is the largest organ in the body and is an excellent defense against the elements and microorganisms. When an ingrown toenail pierces or breaks the skin, it can easily become infected with bacteria and extend to the skin around the nail. This is known as a paronychia which can be acute or chronic, depending on how quickly it developed and how long it lasts. In addition to a bacterial infection, a chronic paronychia may also involve a yeast infection as well.
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Symptoms
If the toenail punctures the skin, it can quickly lead to infection, inflammation, and pain. If infection occurs, the skin around the nail may appear red, puffy or swollen, have blood or pus seeping out, and feel warm to the touch. The infection will start where the nail actually punctured the skin, but can quickly become worse and spread around the entire nail. Pain and discomfort can worsen to the point when wearing shoes is intolerable or bed linens touching the toe causes a restless sleep.
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Causes
Toenails that are overly curved or hooked at the sides are more likely to dig into the skin, causing pain. Sweaty feet are more susceptible to ingrown toenails because overly moist skin is weak and punctures more easily and creates movement in the shoes displacing soft tissues around the nail. Cutting toenails too short or ripping them off can leave a spike of nail in the corner that will pierce the skin as it grows. Ill-fitting footwear that is too tight, narrow or shallow can press on toes and cause an ingrown toenail. Injury to the toe caused by stubbing or kicking a ball repetitively, can inadvertently drive a sharp corner of the nail into the skin. Bacteria is always around and is not necessarily bad, but a break in the protective skin layer can lead to unexpected infection.
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Treatment
Removing the offending nail is key and is best done by a medical footcare clinician. To help ease inflammation and pain, an at-home Epsom salt water soak for 5-10 minutes is helpful as it will draw out pus and infection. An antibacterial cream or ointment applied to the infected site will help control infection causing bacteria and may even resolve it all together. Always make sure shoes fit well and allow toes to move freely and if cutting your nails at home, cut them straight across and not too short.
